38D2109826 CLIA NUMBER - PMG MEDFORD MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 38D2109826
  • Facility Name: PMG MEDFORD MEDICAL CLINIC
  • Facility Address: 3225 HILLCREST PARK DR
    MEDFORD, OR
    ZIP 97504
  • Facility Phone: 541 774-5700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GRANT JOLLIFFE FNP
  • NPI Number: 1063705887
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D2109826
LAB Type Physician Office
Facility Name PMG MEDFORD MEDICAL CLINIC
Street 3225 HILLCREST PARK DR
City MEDFORD
State OR
ZIP 97504
Phone 541 774-5700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2024
Certificate Expiration Date 3/1/2026
Facility Type Physician Office
Lab Director GRANT JOLLIFFE FNP

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This page was last updated on: 9/29/2025